Nutrition Exam 1
Contrast the actions of insulin and glucagon.
- Insulin: secreted in response to HIGH blood glucose levels - Glucagon: secreted in response to LOW blood glucose levels
grains
1 slice bread 1 small tortilla 1 cup ready to eat cereal ½ cup cooked rice, pasta, cereal 5 small whole wheat crackers Choosing WHOLE grains Intact, ground or flaked seeds of cereal grains More fiber and micronutrients (especially vitamins and minerals)
Describe blood glucose regulation - what happens to blood sugar levels and hormone secretion following consumption of a carbohydrate-rich meal?
1. Glucose levels elevated 2. pancreas releases insulin 3. Glucose enters cells and used for energy consumption or converted to glycogen 4. normal blood glucose 5. Low 6. pancreas releases glucagen 7. glycogen is broken down to glucose 8. synthesis of glucose from amino acids 9. Normal levels restored
What order should solid foods be introduced to an infant's diet?
1. breastmilk At about 6 months slowly started introducing food 2. rice milk 3. puree peas 4. puree fruit 5. mixed meal
Describe the enteroheptic circulation of bile.
1. made in liver from cholesteral 2. gallbladder stores 3. bile secreted in dudodenum, jejunum, illeum 4. 90 percent goes back in hepatic vein to liver
What percentage of a typical adult's body weight is water?
50-60% of body weight is water
Be familiar with fasting blood glucose levels associated with normal, pre-diabetes, and diabetes.
70-99 mg/dL = normal 100-125 mg/dL = pre-diabetes 126 mg/dL + = diabetes
What is Healthy People 2020?
A report that includes national health promotion and disease prevention goals that America should meet by 2020
Define anosmia, hypogeusia, and ageusia. Recommendations for these conditions
Anosmia: complete inability to detect odors Hypogeusia: diminished ability to taste Ageusia: total loss of taste Ageusia: preference for crunchy foods due to texture
What are the most common alternative sweeteners? In general, are they safe?
Aspartame (equal/nutrasweet) Saccharin (sweet'nlow) Sucralose (splenda) Stevia - concentrated amount of powder that came from a plant
Describe the simple carbohydrate consumption patterns of American adults.
Average American consumes 32 teaspoons of sugar everyday
Which nutrients are organic?
Carbs, fats, protein, vitamins
List the six classes of nutrients.
Carbs, proteins, fat (energy), water, minerals, vitamins
List the different parts of the large intestine.
Cecum, ileocecal sphincter, ascending colon, transcending colon, descending colon, sigmoid colon, rectum, anus
Nutrition is a dynamic science
Constantly changing: humans, food choices, environments, knowledge, others
Foods and the nutrients they contain are not cure-alls.
Diet is only one aspect that influences a person's health
Food is the best source of nutrients
Dietary supplement: contains a vitamin, mineral, herb/plant product, amino acids, or dietary substance that supplements the diet (FDA does not regulate) "more is not always better"
Compare the process of digestion and absorption
Digestion: breaking down large food molecules into nutrients the body can use. Absorption: uptake and removal of nutrients from the GIT and into blood or lymphatic vessels
Explain the digestion of carbohydrates, including where it begins and important enzymes.
Disaccharide >>>Monosaccharide >>>absorbed from small intestine>>>liver Mouth Salivary amylase Starch Chewing tears fiber in foods Stomach Acidity of stomach halts starch digestion Bc protein > denatured Not much enzymatic digestion of Fiber delays stomach emptying Small intestine Pancreatic amylase Starch broken down to maltose Maltase Sucrase Lactase Intestinal cells now absorb monosaccharides Large intestine Fiber and resistant starches enter large intestine unchanged Fermentation of fiber Byproducts = gas and short chain fatty acids (SCFA)
What is Dumping Syndrome - common symptoms and treatment options?
Dumping syndrome: a disorder that occurs when chyme flows too rapidly into the small intestine. Large particles of food are not broken down properly. Symptoms: nausea, sweating, rapid heart rate, weakness, cramping Treatment: eating fewer sugary foods, eating smaller meals, and taking certain medications can help manage dumping syndrome.
What signs/symptoms are most common with type 2 diabetes.
Excessive thirst Frequent urination Blurry vision Foot pain Sores that don't heal
What are the three classes of polysaccharides? Compare Starch and Glycogen
Fiber, Starch, Glycogen Starch is made of amylose (linear) and amylopectin (branched), alphaglycocidic bonds Glycogen: stored glucose, muscles and liver
What recommendations do you have for the treatment and management of diabetes from a dietary and lifestyle standpoint?
Focus on whole grains, vegetables, fruits, legumes, poultry, fish, low-fat dairy Carbohydrate (focus on nutrient dense carbs) - carbohydrate counting Simple sugar and starch consumption is regulated and consistent for maintaining blood glucose levels - consistent carbohydrate intake Physical activity - especially with Type 2 diabetes helpful because obesity is a big factor, for some with Type 2 if they lose weight it goes away
What are the key functions of the stomach?
Food reservoir: (typical meal 4-6 cups) Maximum capacity 16 cups Production and secretion of gastric juices Grinds bolus into chyme Chyme released through pyloric sphincter
How are galactose and fructose structurally the same? Different?
Galactose and Fructose both can be converted to glucose Fructose: occurs free in nature Galactose: does not occur free in nature
What are the three monosaccharides and which is the most common?
Glucose : Most common monosaccharide Quick energy Most commonly consumed as part of a starch or disaccharide Structure (memorize) Fructose :Fruit sugar Occurs mostly in fruit, honey, part of table sugar Can be converted to glucose Galactose :Part of milk sugar Does not occur free in nature Can be converted to glucose
How do humans store glucose in the body? Where is most stored?
Glucose stored as GLYCOGEN Major storage sites: 1/3 in liver (but more generous) 2/3 in muscles Athletes train muscles to hold more glucose Decrease BG levels > LIVER releases stored glycogen
What is HFCS and how is it the same/different from table sugar (sucrose)?
HFCS is much sweeter than glucose and easily obtained through processing corn, same amount of fructose as sucrose
Compare the HealthyEating Plate, and Canadian Food Guide to MyPlate - identify at least three differences.
HealthyEating Plate: whole grain vs grain, healthy protein (red meat=unhealthy), water instead of dairy, physical activity included, section for healthy oils Canadian Food Guide: water as choice of drink, no dairy, not a lot of red meat, plenty of fruit and vegges
List the top 10 leading causes of death in the US? Which are related to diet?
Heart disease, cancer, chronic lower respiratory infection, accidents, stroke, Alzheimer's, diabetes, influenza, pneumonia, kidney disease, suicide, other Related to diet: Heart disease, cancer, stroke, Alzheimers, Kidney disease
Define hypoglycemia and hyperglycemia.
Hypoglycemia: low blood glucose levels Hyperglycemia: elevated blood glucose levels
Be familiar with the digestive disorders that are described in the textbook and were reviewed as part of the group case study. See case study sheet For each, describe what the condition is as well as how to manage and/or prevent the condition from a dietary standpoint. See case study sheet
IBD: chronic inflammation of GI tract, inhibits nutrient absorption IBS: a condition characterized by intestinal cramps and abdominal bowel functions, less severe, no inflammation Cure: eat high fiber foods, high probiotic foods, medication Heart Burn: passage of acidic chyme from stomach to esophogas due to lower esophageal sphincter not working Cure: no smoking, eat slowly, don't lie don after meals Chron's: (IBD) Immune system cells invade the intestinal lining causing patches of inflammation Celiac Disease: autoimmune disorder that results in poor absorption of nutrients in small intestine
What is lactose intolerance and how is it treated?
Inability to digest lactose, lack lactase 30-50 million Americans Symptoms Nausea Abdominal pain Gas Diarrhea Treatment Lactose free products Small amounts of food that contain lactose Enzyme pills
Describe what a whole grain bread contains and why consumption is beneficial to health.
Intact, ground or flaked seeds of cereal grains More fiber and micronutrients (especially vitamins and minerals)
Six key Nutrient Concepts
Know all
Describe the key functions of the SI.
Longest part of GI tract (narrow), large surface area (size of tennis court). Digestion is completed here, major site of nutrient absorption, receives secretions from gallbladder( bile) and pancreas(enzymes/bicarbonate).
Compare macro and micronutrients, providing examples of each.
Macro: nutrients that the body needs in large amounts, carbs, proteins, fats Micro: nutrient required in small dose, vitamins, minerals
According to the AMDR's, what percentage of total daily kcals should be supplied by carbohydrates, fat, and protein?
Macronutrient Percent of total kcal Carbohydrate 45-65 > 55 Fat 20-35 > 30 Protein 10-35 > 15
Dairy
Make fat free or low fat choices (fat free or low fat milk - cow soy almond, low fat cheese, greek yogurt) Dairy food equivalents 1 cup milk 1 cup yogurt 1 ½ oz natural cheese 1/3 cup shredded cheese 2 oz processed cheese
Protein
Make lean or low fat choices (fish, legumes, eggs, lean meat, nuts, seeds) Protein food equivalents 1 oz cooked lean pork, ham, poultry, fish 1 egg 1 tbsp peanut butter ½ oz nuts ¼ cup cooked beans
Compare the body composition of males and females.
Males have higher muscle mass since more water is stored, males can also loose water faster, store more protein and water, as well as less fat
Malnutrition includes overnutrition & undernutrition
Malnutrition: (mal=bad) body improperly nourished.
What does hemoglobin A1c tell you about a person's health?
Marker of average BG levels over the past 2-3 months Elevated in diabetes A1c level 4.5-5.7% = normal 5.7-6.4% = pre-diabetes 6.5% + = diabetes
How is type 1 diabetes treated?
Medications - mandatory for Type 1, sometimes Type 2 has to take insulin Insulin shots Insulin pumps Sugar pill - medication that decreases insulin resistance (Type 2 only)
Where are taste buds located on the tongue? What happens to taste buds as you age?
Most are located on the underside and tip of the tongue (prevents damage to the tongue), as you age, you loose a significant number of taste buds
What are the components of gastric juice and why is each important?
Mucus: secrets mucin, a carb rich substance that forms mucus when combined with water. "coats" HCl: highly acidic environment breaks down food Intrinsic factor: substance necessary for absorbing vitamin B-12 Enzymes: pepsin Gastrin: hormone that stimulates stomach motility and the secretory activity of stomach glands
What is the definition of a conditionally essential nutrient?
Normally not essential but become essential under certain conditions
Compare the new FDA food label to the "old" food label, which is still found on many products - what are key differences?
Number of calories per serving in very bold print More information about carbohydrate contents Amount of "total carbohydrates" in serving is shown Amount of dietary fiber and total sugars are provided
Most foods are mixtures of nutrients
Nutrient dense: supplies more vitamins and minerals in relation to total kcals Energy density: amount of energy a food provides per given weight of the food (foods with a lot of calories)
What is the empty-calorie allowance
Once you meet all other food groups, the calories that are left over can be empty calories.
What is required as part of the Nutrition Education and Labeling Act of 1990?
Packaged foods must state the following: Common or usual name of the product Name and address of manufacturer, packer, or distributor Net contents in terms of weight, measure, or count Nutrient contents of the product
Which restaurants must provide calorie labeling?
Patient protection and affordable care act of 2010 If 20 or more locations, calorie info listed for standard menu items
What are daily values and how are they utilized?
Percentages designed to help consumers compare nutrient contents of packaged food to make more healthful choices Standards developed for labeling purposes Adult DVs based on a 2000 kcal diet How can you use DVS? Am I eating a little or a lot a nutrient? Compare similar products
What is a food group plan?
Plan that groups foods according to certain characteristics
Describe the labeling of organic foods/beverages.
Produced without the use of Antibiotics Hormones Synthetic fertilizers and pesticides Genetic improvements Ionizing radiation Have to rely on natural ways to get rid of bugs and diseases Lose more of the crop
How many kcals are provided per gram of nutrients Use those numbers to then calculate how many kcal are in a particular food.
Protein: 4 grams, 15% Fat: 9 grams, 30% Alc: 7 grams Carbs: 4 grams, 55% calculate by multiplying by calories diet is based on by percentage needed and dividing by grams
What are the main functions of the LI?
Receives remaining water and undigested material through ileocecal Little absorption- primarily water and salts Bacterial production Formation and storage of feces
What are the components to the Dietary Reference Intakes?
Recommended Dietary Allowance (RDA) Adequate intake (AI) Tolerable upper intake level (UL)
What are the definitions of reduced sugar, fat-free, and high-fiber?
Reduced sugar - at least 25% less sugar than original Fat-free - less than 0.5 g fat per serving High-fiber - more than 5 g fiber per serving (must also be low-fat)
What is a health claim? Who approves? Provide two examples.
Regulated by FDA Specific wording requirements CANNOT "diagnose, mitigate, or treat disease" Examples "Diets low in saturated fat and cholesterol may reduce the risk of heart disease" "Adequate calcium and vitamin D as part of a healthful diet, along with physical activity, may reduce the risk of osteoporosis in later life."
What are the components of saliva?
Saliva is 99% water Mucus Lysozyme (antibacterial) Salivary amylase (breaks down starch) Lingual lipase (infants only) breaks down fats and lipids in mouth since infants have undeveloped digestive tract and bc breast milk is very fatty.
Who develops the DRIs? How are they utilized?
Set of energy and nutrient intake standards Used for planning and assessing diets Developed by Food and Nutrition Board Estimated average requirement amount of a nutrient that should me the needs of 50% of healthy population Instead use RDA - what 97-98% of population can ideally consume Recommended Dietary Allowance Represents a person's nutrient intake GOAL Meets the need of nearly all (97-98%) of healthy individuals in a life stage/gender group Adequate Intake (AI) SAME concept as RDA Used when not enough information is available to determine human requirements "BEST GUESS" Examples: vitamin K, sodium Tolerable Upper Intake Level (UL) How much is too much? Highest average amount of a nutrient that is unlikely to harm most people when consumed on a daily basis
What is the difference between a simple and complex carbohydrate?
Simple: mono and disaccharides Complex: polysaccharides (3 or more saccharides)
What are potential health benefits of consuming soluble fiber? Insoluble fiber? Both types of fiber?
Soluble: delays stomach emptying, slows glucose absorption, may lower blood cholesterol levels Insoluble: increases fecal bulk, speeds passage through GIT Both: reduce risk of diabetes, promote optimal body weight, reduce risk for heart disease, promote healthy GIT, reduce risk of colon cancer
What are examples of soluble and insoluble sources of fiber?
Soluble: pectin, helecellulose, gum, oatmeal Insoluble: cellulose, vegetables, whole grain
Define glycemic index and glycemic load and how they impact insulin secretion and blood glucose levels.
Standards that reflect the body's insulin response to carbohydrate-containing food GI = way of classifying food by comparing the rise in blood glucose that occurs after eating a sample of food that supplies 50 g of digestible carbohydrate to the rise that occurs after eating a standard source of carbohydrate, such as a slice of white bread GL = grams of carbohydrate in a serving of food multiplied by the food's GI -GL = more realistic way of relating foods because value indicates the relative rise in blood glucose levels after eating a typical serving of carbohydrate-containing food
What is the definition of an essential nutrient?
Substance that must be obtained in the diet because the body either cannot make them or cannot make adequate amounts of them
What are the three disaccharides and what monosaccharides make them up?
Sucrose = glucose + fructose Table sugar Lactose = glucose + galactose Milk sugar Maltose = glucose + glucose Malt sugar Formed through break down of starch and glycogen
What are the accessory components to the GIT?
Teeth, tongue, salivary glands, liver, gallbladder, pancreas
Describe the importance of the oral cavity in digestion and absorption.
Teeth: break food into smaller pieces Tongue: taste buds, initiates swallowing reflex Salivary glands: secrete saliva (4-6 cups/day)
What nutrients must be listed on the NEW label?
Total fat Saturated fat Trans fat Cholesterol Sodium Total carbohydrate Fiber Total sugars Added sugars Protein Vitamin D Potassium Calcium Iron
Compare and contrast Type 1 and Type 2 diabetes.
Type 1 Autoimmune disease: body basically attacking itself Pancreas stops producing insulin Type 2 Insulin becomes RESISTANT (may be produced, but does not do its job)
What are the locations of the UES, LES, pyloric, and ileocecal sphincters?
UES: upper esophageal sphincter and allows a mass of food to enter esophagus LES: lower esophageal sphincter and controls the flow of material into the upper stomach Pyloric: region of stomach that regulates the flow of chyme from stomach to small intestine
Fruits
Variety No more than 1/3 as fruit juice (apples, blueberries, oranges, dried fruit) Fruit equivalents 1 small apple 8 large strawberries 1 cup diced melon 1 cup applesauce ½ cup dried fruit
Vegetables
Variety from all live sub groups several times a week (dark green, orange and deep yellow, legumes, starchy, other) Vegetable equivalents 1 cup raw or cooked veggies, mashed potatoes 1 cup veggie juice 2 cups leafy greens 1 large sweet potato
Variety, moderation, and balance can help ensure a diet's nutritional adequacy
Variety: eat foods from each food group Moderation: eat reasonable amounts of each food Balance: eat an appropriate number of kcal and physical activity
What are the importance of the villi, microvilli, and crypts?
Villi: fingerlike projections, maximize nutrient absorption. Microvilli: hairlike projections, traps nutrients. Crypt: important for secretion of intestinal juices
Describe the bacterial composition of the LI.
a healthy colon is home to 10 trillion bacteria from 400 different species. Probiotic: live microorganisms Prebiotic: food components that beneficial bacteria in LI use for fuel
What substance is secreted to help neutralize the acidic chyme entering the SI?
bicarbonate ions
What is bile made from?
cholesterol
What are the three layers of muscle of the stomach wall? Why are they important?
circular, oblique, longitudinal, they are important for mechanical digestion
What type of reaction forms disaccharides?
condensation reaction: two molecules bond to form larger molecules
Why is dietary fiber non-digestible?
contains betaglycodic bonds, nondigestible
How does eating fiber impact stomach emptying?
delays stomach emptying
Describe how ingredients are listed on the ingredient list.
descending order according to weight
What are the three parts to the SI?
duodenum, jejunum, ileum
How long does food stay in the stomach?
empties every 4 hours
What are at least five factors that influence a person's food choices?
environment, taste, cost, religion, seasonal mood, friends, family, media, education, job, how it affects body after you eat
What prevents food from entering the trachea?
epiglottis prevents the bolus from entering the trachea
Why is bile important?
essential for fat digestion and absorption
List at least three signs /symptoms of diabetes.
excessive thirst, frequent urination, blurred vision
Which nutrient must enter the lymphatic vessels (lacteals) before the blood vessels?
fat and fat soluble vitamins
Oil
healthy sources: fatty fish, olive oil, nuts, avocado, canola oil 1 tbsp oil 2 tbsp salad dressing 4 large olives 1/2 avocados 2 tbsp peanut butter 1 oz nuts
What are examples of foods rich in simple sugars?
honey, fruit, some veges, soda, anything with table sugar or high fructose corn sugar
Are infants born with a preference for sweet or salt or is that preference developed?
infants are born with a preference, affected by order you introduce food
Describe peristalsis.
involuntary waves of muscular contractions that help move material through most of the digestive tract
To what organ do most nutrients go following absorption from the SI?
large intestine
List the order of the primary components of the GIT.
mouth, pharynx, esophagus, stomach, small intestine, large intestine (colon), rectum, anus
What are contributing factors to type 2 diabetes?
obesisty, gestational diabetes
Which fatty acids are essential?
omega 3 and omega 6
What is the pH of chyme in the stomach (after a couple of hours)?
ph=2
What are the major food groups that are a component of MyPlate?
protein, veges, fruit, dairy, grains
What dietary recommendations would you make for a person who does not have a gallbladder?
reduce fat intake and eat healthy fats because gallbladder cannot store anymore, spread out fat consumption
What are examples of times when nutrients may become conditionally essential?
serious illness, certain amino acids in those with kidney or liver disease
Contrast simple diffusion, facilitated diffusion, active transport, osmosis, and endocytosis.
simple diffusion: occurs when nutrient is higher in lumen then endocyte, nutrient moves high to low, no energy input needed, many water soluble vitamins, lipids, minerals Facilitated: enterocytes absorb some nutrients by facillitated diffusion, moves down concentration gradient with special transport protein active transport: transport protein and energy, nutrients from lumen, nutrient is higher in cell then lumen Osmosis: water moves freely because of concentration gradient is created by the absorption of water soluble nutrients, absorb most water Endocytosis: few instances, plasma membrane surrounds and swallows large substances, such as entirely large proteins, common in infants
What role do sphincters play?
sphincters control the flow of food in the GIT
What advice do you have for young adults wanting to increase their dietary fiber intake?
start slowly, drink lots of water, know your body
What are the five basic tastes?
sweet, sour, salty, bitter, umami
What are general characteristics of artificial sweeteners?
synthetic compounds, elicit intense sweet taste, K-cal free
What role does the esophagus play in digestion?
the muscular tube that extends about 10 inches from pharynx to stomach, transfers bolus to stomach
How is the pancreas important for digestion and absorption?
the pancreas produces and secretes many of the enzymes that break down carbs, protein, and fat in the GI tract. The pancreas also secretes bicarbonate ions.
Anatomically, what is a sphincter?
thickened areas of circular muscle
In general, what are foods we eat too much of in the US? Too little?
too much: red meat, candy, cheese, sugary drinks, refrained grain products Too little: fruits, vegetables, fish, whole grains, low fat fairy
What elements are found in each of the six classes of nutrients?
water: hydrogen and oxygen fat: carbon, oxygen, hydrogen Carbs: carbon, oxygen, hydrogen Protein: carbon, oxygen, hydrogen, nitrogen Vitamins: carbon, oxygen, hydrogen, some nitrogen Minerals: Minerals
